April 13, 2010 — Dr. Pamela Geller, associate professor of psychology, OB/GYN and public health, and director of the Student Counseling Center on Drexel’s Hahnemann campus, was, along with her colleagues, recently awarded the 2010 APGO e-ERA award for an online curriculum she developed about pregnancy loss and post-loss care. The award was presented on behalf of the Association of Professors of Gynecology and Obstetrics (APGO), the APGO Undergraduate Medical Education Committee (UPEC), and the Electronic Educational Resource Award (e-ERA) Selection Committee.

Geller said she developed the computer-based curriculum, “Psychological and Medical Aspects of Pregnancy Loss,” in order to “educate medical students, OB/GYN residents and other healthcare professionals about pregnancy loss and how to work more sensitively and effectively with women and their families following such loss.”

It’s easy to see why APGO held Geller’s site in such high esteem: it’s easy to navigate and the curriculum is user-friendly, informative, and cleverly designed. Video segments that feature Geller, along with other medical experts, are interspersed throughout the rest of the curriculum, which features Powerpoint-style lectures and informational pages.

In addition to the informative video segments by Geller and her colleagues, the curriculum includes interviews with real patients sharing their personal stories. These women—their stories, their backgrounds, their complex emotions, and their perseverance—are the basis behind Geller’s research. Geller’s curriculum aims to educate medical students and healthcare professionals about pregnancy loss, but its main goal is to ensure that women who have suffered a loss are treated with sensitivity and respect—not as just another patient.

Lydia, one of the women interviewed, describes the moment when her OB/GYN told her, after an ultrasound determined she had miscarried, that it was not a “viable pregnancy.” Lydia goes on to add that the doctor was much more sympathetic and comforting than his original language implied, but as Dr. Geller and the other patient interviews made clear, this is not always the case.

When women first learn of their pregnancy loss, medical professionals should show “acknowledgement that there was a loss … and sympathy; it doesn’t take a lot,” Geller said. However, some physicians are concerned about litigation, and thus steer clear of saying anything beyond the basic medical facts.

Doctors see miscarriages and stillbirths so often that these cases become, for some, routine, according to Dr. Geller. “In their mind, it’s a common event. So they forget what that means to that individual woman,” she continued.

Medical professionals sometimes become entirely forgetful of the emotionality of pregnancy loss, using a “humorous and light-hearted” tone as they relay the news to their patient. Geller described how one woman’s physician had exclaimed, “Yep, no life there!” upon discovering that her pregnancy was not viable.

Hearing stories like these, and listening to the sense of exhaustion in the voices of the online case studies, makes it clear why Dr. Geller wants to help women receive more beneficial post-loss care, and why she has developed this supportive curriculum.

From a psychological perspective, Geller’s research is endlessly fascinating—and saddening. Women who experience pregnancy loss often fall into a deep depression, which sometimes includes feelings of self-blame, a sense of worthlessness, anxiety, and even Post Traumatic Stress Disorder (PTSD). Combined with these challenges are even more complex emotions.

“Not all women have the same experiences, but for some, it’s like intense grief…It’s a loss of hope, dreams, [and] expectations,” Geller explained.

Geller went on to describe how some women who experience such loss will have difficulty parting with objects they purchased for the child. This is a typical part of the grieving process, and something that many survivors experience.

Even greater than the physical loss, however, is the emotional loss. “Women often ask… ‘Am I still a mother?’” Geller said. “That role isn’t taken away [even though] their child is no longer living.”

Geller described the overwhelming sense of failure many woman feel. Depression, feelings of worthlessness and identity loss, among other issues, are not matters to be taken lightly. It is important for medical professionals to be attuned to when a woman needs psychological care.

Geller explained that support groups can be beneficial to post-loss women—particularly when their partners are experiencing post-loss symptoms as well, as these might make them less capable of offering support.

“A lot of women say they have no one to talk to because their partners deal with [the loss] differently…The men won’t necessarily talk about it [and] the women find that their partners are inaccessible to them.”

Women who are experiencing any of these post-loss situations should seek help beyond their general practitioner—and Dr. Geller’s online curriculum is an excellent place to start. Women can listen to the case study interviews and hear the experiences of others; they can also watch an expert panel discuss common post-loss scenarios and questions.

But it is the medical professionals, particularly those who have difficulty with expressing empathy to post-loss patients, who should spend extra time reviewing Geller’s curriculum. The website provides a three-step video segment that offers clinicians advice on how to build a trusting relationship with patients. In addition, Geller is interested in developing a video program that allows medical students to practice clinical skills, such as communicating with post-loss patients, and then receive immediate feedback from physicians who are assessing the student as they practice.

After speaking with Dr. Geller and looking over her curriculum, it is clear that she strongly values collaborative, thorough research, and that she holds the well-being of post-loss women in the highest regard. Dr. Geller is a professor, a counseling center director, a researcher, an advocate for women, and a mother. She strives to always continue to learn and to never stop caring about her patients—her goal, now, is to ensure that medical students and clinicians do the same.